Objectives

Methods

Between Sept 1, 2011 and Aug 31st 2012, 3068 elective cardiac, orthopedic, spine, vascular, thoracic and neurosurgery patients were treated with CHG wipes the night prior and day of surgery and received intranasal PDT in the preoperative waiting area. Weekend cases, procedures performed after the pre-operative dayshift, and emergency cases going directly to the operating room were not eligible. SSI surveillance remained unchanged from previous years and patients were followed for a minimum of three months. Results were compared to a historical control group consisting of 12,387 patients over four years and to a concurrent control group of 196 untreated patients.

Results

A significant reduction in the SSI rate was observed after the intervention [historical-control group 2.7% and treatment group 1.6% (p <0.0001 RR 1.0114)]. The risk of having a Staphylococcus aureus infection was higher in the concurrent untreated (61%= 11/18 infections) compared to the treated group (32%=16/50 infections). The reduction in SSIs compared to the historical rates resulted in a cost avoidance of approximately $1.2 Million (Can) and would have permitted approximately 140 additional surgeries to be performed.

Conclusion

The combination of PDT and CHG wipes immediately pre-operatively reduces SSIs and is cost-effective.

Disclosure of interest

E. Bryce Grant/Research support from The Vancouver Hospital Foundation funded this project. Ondine Biomedical discounted the cost of PDT supplies and provided technical advice but had no role in data collection, analysis or interpretation of results, T. Wong Grant/Research support from The Vancouver Hospital Foundation funded this project. Ondine Biomedical discounted the cost of PDT supplies and provided technical advice but had no role in data collection, analysis or interpretation of results, D. Roscoe Grant/Research support from The Vancouver Hospital Foundation funded this project. Ondine Biomedical discounted the cost of PDT supplies and provided technical advice but had no role in data collection, analysis or interpretation of results, L. Forrester Grant/Research support from The Vancouver Hospital Foundation funded this project. Ondine Biomedical discounted the cost of PDT supplies and provided technical advice but had no role in data collection, analysis or interpretation of results, B. Masri Grant/Research support from The Vancouver Hospital Foundation funded this project. Ondine Biomedical discounted the cost of PDT supplies and provided technical advice but had no role in data collection, analysis or interpretation of results.

Copyright information

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

E Bryce

1

T Wong

1

D Roscoe

1

L Forrester

2

B Masri

3

The Vancouver General Hospital Pre-operative Decolonization Therapy Team